Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

IIR 18-286 – HSR Study

IIR 18-286
Effect of Medication Management at Home Via Pharmacy Home Televisits
William W Hung, MD AB MPH
James J. Peters VA Medical Center, Bronx, NY
Bronx, NY
Lauren Moo MD
VA Bedford HealthCare System, Bedford, MA
Bedford, MA
Funding Period: May 2020 - September 2025


Older adults are more likely to suffer from multiple chronic conditions, to be prescribed multiple medications, and are more susceptible to adverse effects of medications. In addition, older adults often use over-the-counter medications and supplements, further complicating their medication regimen. Complex medication regimens are potentially harmful to older adults due to potential drug interactions, potentially inappropriate prescribing or over-the-counter drug use, and medication non-adherence that may lead to poor control of chronic disease. Interventions aimed at reducing medication discrepancy in the ambulatory clinic setting, such as the review of written medication lists, and implementation of “brown bag” reconciliation (asking patients to bring in all medication bottles for review in the clinic) continues to be challenging and have limited success. Clinical pharmacist led interventions to improve appropriate medication use in older adults, including the application of the START/STOPP criteria, have demonstrated effectiveness in reducing adverse drug events. With the increased capability of VA telemedicine to reach Veteran in their homes, delivering medication management via televisit by clinical pharmacists has the potential to yield similar benefits for a larger number of older Veterans. Telemedicine is an increasingly vital component within VHA to increase access and improve quality of care. By extending care beyond brick-and-mortar clinics, telemedicine increases the reach of care teams and is more convenient for patients, resulting in improved patient satisfaction. Using the capability of telemedicine to reach patients' homes, we propose to examine the effect of medication management by clinical pharmacists via home video televisits, as home video visits have the potential to provide direct visualization of medications in older adults' homes, thereby reducing medication discrepancy and increasing medication adherence. Pharmacist management for older adult medication regimen may also improve appropriate medication use in older adults through direct pharmacist-patient interview and education. In support of this application, preliminary data from our team of investigators demonstrate acceptability of video televisits by older adults, that there is good uptake by patients and VA providers, and that video televisits into the home are feasible. In this study, we aim to develop a protocol for pharmacy home televisits for medication management in older adults who have multiple chronic conditions and are on multiple medications. We will then conduct a randomized trial with hybrid effectiveness Type I design to examine the effect of these televisits on appropriate medication use, medication discrepancies, adherence and adverse drug events and observe and gather information on implementation. We anticipate that a pharmacist led medication management home televisit intervention will lead to reduction in potentially inappropriate use of medication, reduction in medication discrepancies, increased medication adherence and reduced adverse drug events in older adults compared to older adults receiving usual care. We will also examine the barriers and facilitators in implementing the intervention so that the study findings may inform future implementation.

External Links for this Project

NIH Reporter

Grant Number: I01HX002826-01A1

Dimensions for VA

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

Learn more about Dimensions for VA.

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
    Search Dimensions for this project


Journal Articles

  1. Hawley CE, Wagner C, Venegas MD, Genovese N, Triantafylidis LK, McCullough MB, Beizer JL, Hung WW, Moo LR. Connecting the disconnected: Leveraging an in-home team member for video visits for older adults. Journal of the American Geriatrics Society. 2023 Nov 13. [view]

DRA: Aging, Older Veterans' Health and Care, Health Systems, Acute and Combat-Related Injury
DRE: Technology Development and Assessment, TRL - Applied/Translational
Keywords: Caregiving, Home Care, Medication Management, Models of Care, Pharmacology, Self-Care
MeSH Terms: None at this time.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.